When the Israeli Health Ministry decided to provide the Human Papillomavirus (HPV) vaccine to 8th grade girls in 2013 and to boys in 2015, the mutterings online about opting-out surprised me. To date, HPV vaccination coverage in Israel hovers around 10% – compared to the United States where 60% of preteens have completed the full course of vaccination. The continued low rate of vaccination despite the availability of a very safe and effective vaccine is deeply troubling, and misconceptions about the two available vaccines – Gardasil and Cervarix – abound. [Read more…]
It is G-d, not the water that purifies – Rachel Kochva
These words were delivered at the consecration of the refurbished mikveh in Migdal Oz on 4.4.17, with gratitude to all those who helped and worked tirelessly to improve the mikveh experience for the women of the kibbutz.
“ R. Akiva says: Fortunate are you O Israel! Before whom do you purify yourselves? [And] who purifies you? Your Father in Heaven! As it is said: ”I will sprinkle upon you pure water and you shall become purified” (Ezekiel 36:25), and it is further said: “The hope [[מקוה of Israel is the Lord” (Jeremiah 17:13), just as a mikvah purifies the defiled so too, does the Holy One Blessed is He, purify Israel.” (Yoma 8:9)
Immersing in the mikveh is a special and often complex and changing experience. [Read more…]
May has been declared Pelvic Pain Awareness Month. So, let’s get more aware!
1) “You just need to relax and have a glass of wine”.
Pelvic pain is often misunderstood or dismissed. The idea that you just need to relax and have a glass of wine is not only inadequate, it undermines the magnitude of what pelvic pain is and can make the sufferer feel incredibly isolated and ashamed. Responses to pelvic pain often reflect a lack of understanding even on part of health care providers; for example, I’ve had many patients who have shared that providers told them it may just be a phase. Even if it is a phase, why should someone continue to suffer when there are treatments that provide relief? In many cases, it’s not just a phase, at a certain point the woman realizes that what she thought was a phase is her life. By then, the effect on a woman and her relationship is more pronounced and the original problem has given birth to other problems. When it comes to pain in other parts of the body, there is hopefully an awareness that regardless of the anxiety element, exploring medical options is essential. Treating pelvic pain should be no different.
2) “There must have been sexual trauma. Maybe you just don’t remember”.
Sadly, the notion that pelvic pain is a sign of a definite sexual trauma history is one that many women with pelvic pain encounter. Can sexual trauma contribute to difficulties with sexual functioning and pelvic pain? Perhaps.There are a variety of conditions that can cause pelvic pain. Telling the person that maybe they were abused but just don’t remember can cause unnecessary distress and in some cases, lead them to look back on their past with a new suspicion. Yes, the mind-body connection is real; I am a fan of therapy modalities that address not just our intellectual perspective but the energy we carry in our bodies. But starting out therapy treatment on a fishing expedition for repressed memories can be damaging and is often futile in curing the pain. Most psychotherapists are not medically trained or ethically allowed to do an exam, make a medical diagnosis, or prescribe medications. It is thus important to collaborate with the appropriate medical professionals.
3) “If you haven’t had children yet, childbirth will resolve it”.
Yet another thing people hear that can give as much anxiety as it gives comfort. Over the years, I have met many newly married women who were experiencing pelvic pain and heard from their friends, relatives, and mental health and medical professionals that the pelvic pain would resolve after giving birth to a baby (never mind the fact that both vaginal and C-section can be influential factors in pelvic pain). Building a healthy sexual life is an adjustment for newly married couples and is greatly encumbered when intercourse is painful, which can lead to an avoidance of sexual activity altogether. It affects both partners; she feels bad physically and emotionally, he feels bad about hurting her. Often the issue becomes an elephant in the bedroom as the couple tries to work around the problem and waits for it to get better. Even if a woman only experiences pelvic pain sometimes, one of the most important components of a positive sex life is a sense of predictability that your body can show up in the way you like. A thought process of, “Will I have pain this time?” can diminish the ability to experience pleasure even if pain is absent. And when we brace for pain, it’s not just in our thoughts and feelings, it’s in our body as well.
Pelvic pain is difficult not just because of the physical pain, but because it is often accompanied by feelings of confusion, loneliness, hopelessness, and in some cases, feeling defective. When it’s an issue that generally isn’t discussed due to embarrassment, the suffering can be silent. Fortunately, more medical professionals have the expertise and tools to treat pelvic pain—there is even a subset of physical therapists called pelvic floor therapists—and people can find resolution to their respective symptoms.
Sigalit Sfachi, Director of Mazor Natural Medicine- The Institute for Foot Health and a medical pedicure teacher, earns her living from the treatment of nail fungus- even so, she chooses to increase awareness of the subject and gives us some important tips on preventing infection in the Mikveh and in general.
What is fungus?
Fungus is a fungal infection that appears on nails, fingers and toes.
There are numerous signs of fungus- the skin may appear scaly or peeling, sometimes , though not always, the area is also itchy or smells. Between the fingers or toes there may be damp, white material (the texture of cottage cheese) and cracks in the skin. The nails can thicken and separate from the base of the finger/toe. Many times the nails lose their transparency, or blacken, become yellow or other colors, depending on the type of fungus.
Even if there is no discomfort when the fungus first appears, it is unaesthetic. Beyond that, in many cases the fungus causes cracks in the skin, which create a high risk of infection that can affect the entire leg, lead to infections in the bone and other serious problems.
How can I treat fungus?
It’s important to remember that fungus is not a life long sentence; it can be treated. Treatment, however, is a process, not a magic drug. It is crucial to follow through with the treatment until the end and not to stop in the middle. Even one slightly infected nail is enough to reinfect the whole area.
There are several ways to treat fungus. Dermatologists generally recommend oral medication. These pills increase the risk of liver problems and therefore it is necessary to accompany the treatment with liver function testing.
There are also innovative laser treatments, but many patients have had the laser treatment and eventually came back to me. It seems the laser treatment has not yet been perfected.
I recommend natural treatment methods. In my clinic, the treatment includes thorough cleaning of all infected areas (which can also be done at home) once a month, and applying medicated ointment or drops throughout the month. This is a long-term treatment with has proven highly effective. The duration of treatment depends on the condition in which you begin. If you arrive at the initial stages of the fungus, when only the skin is affected, the treatment will probably take a month or two. If the fungus has already reached the nail but is still in the initial infection stage, treatment will probably last for about four months. In more severe cases, when the fungus is more advanced, treatment may take up to a year or more.
Fungus does not usually stop spreading or disappear on its own, rather it continues to spread and infect other areas of the body until treated. It is very important not to neglect the situation and let it deteriorate rather to start treatment as soon as possible. I had a patient who had been suffering for years with fungus in one nail, but tolerated the situation and didn’t seek treatment. After getting pregnant all her nails suddenly became infected and only then did she come for treatment.Pregnancy, like other things, may be a catalyst for the development of a fungus.
Even if the fungus is stubborn and does not respond quickly to treatment, we need to be even more stubborn and continue treatment until the fungus is fully eradicated.
Preventive measures are best
The places with the greatest risk of catching fungus are wet, damp places, such as the shower, pool and mikvah. In public spaces the risk of infection increases. Therefore, the first rule of prevention is to always wear clean flip-flops. There is no risk of infection once in the water since pools and mikvaot are treated with chlorine or disinfectant, but the surrounding areas- on the way from the prep room to the mikvah, in the locker rooms, the edge of the pool- are potential breeding grounds for fungus.
In addition, trauma sustained by the nail, for example getting slammed in the door, may increase the risk of contracting fungus because the area is now vulnerable. Fungus is like all viruses and bacteria which are around us all the time, and infect us in opportune moments.
A foot that does not get aired out or cleaned will serve as the perfect breeding ground for fungus, so it is important to use cotton socks, wipe the feet and toes after showering and not leave them damp.
In order not to get infected and also to not infect others it is important to never stand barefoot in public places. Just as every mother warns her children not to sit on a public toilet, so too should she warn them not to walk barefoot in public places.
Once you are infected, it’s important not to touch the fungus so as not to transfer it to other places on the body. A special towel should be assigned to the feet/affected area that will not be used for the rest of the body. After showering (at home) it is important to wash the bath/shower with chlorine or bleach so as not to infect the rest of the family. Sometimes entire families come to me for treatment because one of the family members brings the infection from outside and everyone gets infected.
In the mikveh
You can never know exactly where you got infected, since it takes a while for the fungus to develop, but it’s safe to assume that a considerable number of women are infected in the mikveh.
The mikvaot usually provide flip flops, but the balaniot don’t always have enough time to sterilize them, so the risk of infection remains. Therefore, it is highly recommended not to count on these shoes rather bring shoes from home that you know are clean.
In preparation for the mikveh, of course, you should never stand barefoot on the floor. It is recommended to bring your own towel, and if you want to be extra careful, you should also bring the tools needed for grooming your nails.
Instructions for balaniot
Balaniot and bridal teachers are at an important junction, and can serve a vital role in hygiene education. It is important to take advantage of this and increase awareness. New brides are not yet accustomed to the immersion experience in the mikveh, everything is new to them and they are excited. They are not aware of the things they should be careful about and what they should not do, but rather are focused on what they should do and how to immerse in the right way. The kallah teacher or balanit can contribute from their knowledge of fungus prevention.
Most women trust the balanit regarding the hygiene of the mikvah and its accessories, therefore, the balaniot need to be aware of, and provide, the highest standard of hygiene and to be aware of what is effective and what is not.
There is a simple way to disinfect flip flops- by soaking them in a solution of water and chlorine or bleach for a few minutes and rinsing them off. It is important to soak them thoroughly, if you do not have time to do so it is important not to pass them on to the next woman.
There are many other accessories in the mikveh that may be a source of fungus. The pumice stone is a disaster, because of the holes in it, it can not be fully sterilized. Things that can not be sterilized should never be shared or transferred from one to another. It is highly recommended to bring them from home.
Files and nail clippers must be sterilized between each use by cleaning them with a toothbrush under running water so that no pieces of skin or nails remain, and then soaking them in the special antiseptic (not alcohol, but anti-bacterial and anti-fungal substances). Soaking alone isn’t sufficient, the instrument must first be cleaned of all biological debris such as skin or nails..
In the mikvehs with which I work, they do not put the disinfectants in the room since it is not the woman’s job to disinfect the prep room and accesories, rather the balaniot do it in between women.
In a lecture I gave balaniot, they were shocked when they realized that until now they had improperly disinfected the mikveh accessories. Of course they want to do the best for the women they serve and therefore adopted the right methods. During my tours in mikva’ot, we found solutions for every issue and things did indeed change and improve. The religious council in Jerusalem purchased a special disinfectant on my recommendation for all their mikvaot which brought about a huge change in dozens of mikvaot.
Sigalit will be happy to give a free diagnosis and consultation to all interested. You can contact her by phone at 050-7949020 and at: Mazor Natural Medicine 2 Pines Street, Jerusalem.
As an interior designer, I firmly believe that enhancing the look of a space will make it more inviting. Attention to small details make a big difference. The mikveh experience is much the same.
This mitzvah gives married women the opportunity to pause from our hectic lives and reflect on ourselves, our femininity, our individuality and our connection to Hashem. As we immerse ourselves in the pure mikveh waters, we feel a sense of freshness and newness. The experience is a special, beautiful and spiritual one, helping us to reconnect with Hashem, with ourselves and with our spouses. It is one of the foundations to creating a rejuvenating and exciting marriage as we have the opportunity to recreate a monthly renewal with our spouse.
The mikveh should be a welcoming and appealing place for every woman. Its aesthetics are very important and plays a big part in how some women feel about fulfilling this important mitzvah.
It has been quite amazing to see the emphasis that has been placed on improving the cleanliness and aesthetic design of mikvaot over the last number of years. My experience in designing mikvaot and participating in Yisrael HaYafa’s yearly mikveh competition has allowed me to share my design expertise and contribute to the aesthetics of the mikveh, making them more appealing and inviting to women.
A woman’s first impression of the mikveh is the walkway and entrance. Exterior signage is important to facilitate a newcomer’s easy access. Proper lighting is mandatory. I recommend lighting leading up the walkway to the mikveh as well as by the entrance to the mikveh and specifically by the intercom. Additionally, well manicured greenery or a few potted plants by the entrance door, or even a framed Welcome sign can help set a pleasing and peaceful mood.
The reception area is where a woman is welcomed to the mikveh by a warm and smiling attendant. Women may have to wait a lengthy amount of time, and therefore it should have a comfortable seating area, with perhaps a few accent pillows to give a warm feel to the area. Soft relaxing music will enhance the experience. It should also include a small kitchenette where tea and water are available and a bookcase or a couple of bookshelves stocked with a selection of interesting and inspirational books. A fresh coat of paint and accent walls can be transformative. Incorporate art, décor, fresh cut flowers and accent lighting complementing the general décor of the mikveh.
The preparation rooms should enhance the feeling of peace and calm. It is here that women can take the opportunity to pamper and prepare themselves physically as well as mentally before immersing. These rooms should be clean and comfortable. They should include all the necessary toiletries needed for the preparation process as well as hygienically disinfected utensils nicely laid out in a basket or tray. An upholstered bench or chair will be appreciated. Incorporate a small shelf with a few accent pieces, a framed mirror over the sink and a small tray to lay out one’s jewelry. Soothing soft music, dim lighting and scented lit candles will add to the serenity and spa like feeling. Large plush towels or a robe contribute to a woman’s modesty when being checked or moving from the preparation room to the mikveh itself.
Immersion in the mikveh is the moment a woman restores her spiritual purity. It’s the ultimate moment of renewal. The mikveh itself should be clean and artfully designed. Consider using tiles of contrasting color or figured with flowers. Beautify the tefillot with frames or other creative solutions and allow women their quiet private time to pray for herself and her family.
If possible include a separate area for a woman to blow-dry her hair and apply makeup.The area should be fully
equipped with all the necessities encouraging a woman to take the few extra minutes to beautify herself. Hang a framed mirror over the makeup counter and provide proper task lighting. A full length mirror will also be appreciated.
The key to making the mikveh experience appealing and more inviting is to provide all of the necessities and amenities. An aesthetically pleasing Mikveh will make the overall experience a pleasant one, and contribute to the fulfillment of this important mitzvah.
Originally from Toronto, Canada, Sandy Brudner made Aliyah to Israel with her family. Since making Aliyah, she realized her dream of opening Sandy B Interiors, an Interior Design Studio offering a wide range of Interior Design and Home Styling services. She designs beautiful and functional homes for people living in Israel as well as for people living abroad owning investment or vacation apartments.